| NPI | 1861498909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: IL 036101179) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: IL 036101179) |
| 2086S0129X (Licence: WI 66852) | |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2024-03-21 |