| NPI | 1447491451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101274793) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 063068) |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2024-03-28 |