| NPI | 1396178943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2023-00404) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC RTL228095) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2024-03-01 |