| NPI | 1487666129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME51843) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL me51843) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2025-11-18 |