| NPI | 1437183035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 37196) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301075047) |
| 208600000X Surgery (Licence: CA A96308) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2013-06-06 |