| NPI | 1275506073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: WI 51450-20) |
| Additional Taxonomies | 2086S0129X (Licence: CA G88327) |
| 2086S0129X (Licence: VA 0101250486) | |
| 208600000X Surgery (Licence: CA G88327) | |
| 208600000X Surgery (Licence: WI 51450) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2024-01-22 |