| NPI | 1548314404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD D0060140) |
| Additional Taxonomies | 208600000X Surgery (Licence: DC MD035296) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2023-12-05 |