| NPI | 1225186877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN 31647) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN MD0000031647) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2018-05-02 |