| NPI | 1265449755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2015008157) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: AR N-8118) |
| 208600000X Surgery (Licence: AR N8118) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2015-07-31 |