| NPI | 1396078788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA C134435) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101258987) |
| 208600000X Surgery (Licence: PA MD432458) | |
| 208600000X Surgery (Licence: AZ 51121) | |
| 208600000X Surgery (Licence: DC MD043654) | |
| 208600000X Surgery (Licence: FL ME124345) | |
| 208600000X Surgery (Licence: GA 75137) | |
| 208600000X Surgery (Licence: IL 036.138929) | |
| 208600000X Surgery (Licence: MA 264416) | |
| 208600000X Surgery (Licence: MD D0079723) | |
| 208600000X Surgery (Licence: MI 4301108575) | |
| 208600000X Surgery (Licence: NY 279991-1) | |
| 208600000X Surgery (Licence: NC 2015-01946) | |
| 208600000X Surgery (Licence: OH 127192) | |
| 208D00000X General Practice (Licence: CA C134435) | |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2022-05-05 |