| NPI | 1275662041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD435518) |
| Additional Taxonomies | 208600000X Surgery (Licence: DE C1-0007951) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2012-06-20 |