| NPI | 1912007220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD215189) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 6073614) |
| 208600000X Surgery (Licence: CA G73614) | |
| 208600000X Surgery (Licence: IL 036150765) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2024-02-02 |