| NPI | 1255586301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 34.011581) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 02004384A) |
| 208600000X Surgery (Licence: MI 5101017755) | |
| 208600000X Surgery (Licence: KS 05-44117) | |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2024-01-02 |