| NPI | 1366559742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0030146) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 30146) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2015-02-03 |