| NPI | 1679549786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 41342) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036-098297) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2020-09-08 |