| NPI | 1346574027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ME MD22292) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101247487) |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2018-05-25 |