| NPI | 1508152000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME151134) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2011016933) |
| 208600000X Surgery (Licence: MO 2011034661) | |
| 208600000X Surgery (Licence: MO 2013038165) | |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2023-07-16 |