| NPI | 1538472246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 8693) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 8693) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2010-07-22 |