| NPI | 1356310742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: VA 0101232663) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101232663) |
| 208600000X Surgery (Licence: VA 0101232663) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2023-07-18 |