| NPI | 1093763542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0055743) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2013025596) |
| 208600000X Surgery (Licence: FL ME101924) | |
| 207R00000X Internal Medicine (Licence: CO DR.0055743) | |
| 208600000X Surgery (Licence: WI 1489-TEP) | |
| 208600000X Surgery (Licence: TX N3408) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2024-10-04 |