| NPI | 1427374917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301096656) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A133534) |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2016-07-27 |