| NPI | 1144285701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: DE C1-0002968) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0067498) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2024-10-16 |