| NPI | 1730126087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036053064) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 23362) |
| 208600000X Surgery (Licence: CA C51269) | |
| 208600000X Surgery (Licence: FL ME88434) | |
| 208600000X Surgery (Licence: HI 12182) | |
| 208600000X Surgery (Licence: NE 13266) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2007-07-08 |