| NPI | 1124007851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101-223144) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101223144) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2010-03-10 |