| NPI | 1447272877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2023-02057) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101239438) |
| 208600000X Surgery (Licence: OH 35.085882) | |
| 208600000X Surgery (Licence: MD D0066111) | |
| 208600000X Surgery (Licence: DE C1-0008599) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2025-09-06 |