| NPI | 1144295130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AL 24255) |
| Additional Taxonomies | 193400000X Single Specialty (Licence: AL 24255) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2016-03-04 |