| NPI | 1043201510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VT 042.0013180) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 224180) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2015-06-25 |