| NPI | 1689169559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2023023142) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.073137) |
| Enumeration Date | 2018-06-24 |
| Last Update Date | 2026-06-23 |