| NPI | 1720020308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL OS9781) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036117950) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2012-09-17 |