| NPI | 1184682890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: DE C10007528) |
| Additional Taxonomies | 208D00000X General Practice (Licence: DE C1007528) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2025-01-07 |