| NPI | 1922264191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.123973) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125055373) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2016-06-29 |