| NPI | 1376506360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101232566) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101-232566) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2025-09-24 |