| NPI | 1346218096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 34.008080) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OS015203) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2017-01-01 |