| NPI | 1861715476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX R5053) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125-056483) |
| 2086X0206X Surgery, Surgical Oncology (Licence: TX R5053) | |
| Enumeration Date | 2010-03-10 |
| Last Update Date | 2023-05-10 |