| NPI | 1518109537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: DC MD045874) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101264056) |
| 208600000X Surgery (Licence: MD D0073314) | |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2023-12-26 |