| NPI | 1699938985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN 54772) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036133520) |
| 208600000X Surgery (Licence: MI 4301084078) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2023-12-21 |