| NPI | 1366429037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101-231975) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101231975) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2022-02-08 |