| NPI | 1447430426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL OS14047) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 34005874) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2025-04-14 |