| NPI | 1003096116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NH 18036) |
| Additional Taxonomies | 208600000X Surgery (Licence: ME MD23672) |
| 208600000X Surgery (Licence: MO 2022036080) | |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2024-03-08 |