| NPI | 1447317813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KS 0445698) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2005-01815) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2022-02-11 |