| NPI | 1265586457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0019444) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 19444) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2015-02-10 |