| NPI | 1255343455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 43678) |
| Additional Taxonomies | 208600000X Surgery (Licence: KS 04-28693) |
| 208600000X Surgery (Licence: KS 01-28693) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2021-09-15 |