| NPI | 1548248966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101-036440) |
| Additional Taxonomies | 2086S0129X (Licence: VA 0101036440) |
| 2086S0129X (Licence: VA 0101-036440) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2022-02-10 |