| NPI | 1447543236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: LA 312263) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP1-0040982) |
| 208600000X Surgery (Licence: TX Q1573) | |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2023-10-24 |