| NPI | 1528150646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: LA MD.022651) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 022651) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2010-12-02 |