| NPI | 1356378590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: LA MD.010612) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 010612) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2023-05-08 |