| NPI | 1477730026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AL MD.33601) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA MD.203569) |
| 208600000X Surgery (Licence: GA 001316) | |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2023-01-06 |