| NPI | 1598757411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IA MD-49273) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 036-111683) |
| 208600000X Surgery (Licence: MN 42620) | |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2022-04-05 |