| NPI | 1326027277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MD D0025118) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0025118) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2013-02-14 |