| NPI | 1134273147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 267935) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD426048) |
| 208600000X Surgery (Licence: NH 13736) | |
| 208600000X Surgery (Licence: CA A80625) | |
| 208600000X Surgery (Licence: MI 4301079457) | |
| 208600000X Surgery (Licence: OH 35097760) | |
| 208600000X Surgery (Licence: IL 036129009) | |
| 208600000X Surgery (Licence: CT 51339) | |
| 208600000X Surgery (Licence: TX Q0609) | |
| 208600000X Surgery (Licence: FL ME119874) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2017-03-18 |