| NPI | 1427240589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301093725) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A88850) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2023-11-27 |