| NPI | 1841374758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME134233) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036126594) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2021-03-31 |