| NPI | 1336881184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AK 1336881184) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 1336881184) |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2026-02-12 |