| NPI | 1427286822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME157958) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125055921) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2023-09-25 |