| NPI | 1336171917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME53591) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME53591) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2016-01-19 |