| NPI | 1518186832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.090333) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 57008400) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2024-02-29 |