| NPI | 1548209760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: HI MD12309) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD434663) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2016-12-28 |