| NPI | 1477949162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0071391) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 5927) |
| 208600000X Surgery (Licence: WI 66926-20) | |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2023-09-06 |