| NPI | 1528096385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: DC MD21778) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101049185) |
| 208600000X Surgery (Licence: MD D541418) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2026-09-08 |