| NPI | 1144280116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AR E-19369) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX H7963) |
| 208600000X Surgery (Licence: GA 067203) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2025-06-04 |