| NPI | 1295288769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0062864) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO TL0006058) |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2024-01-02 |