| NPI | 1407142342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA 184022) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 248742) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2024-02-12 |