| NPI | 1427463256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KS 04-42033) |
| Additional Taxonomies | 208600000X Surgery (Licence: KS 94-08315) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2025-06-11 |