| NPI | 1558430181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN 69860) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35-091634) |
| 208600000X Surgery (Licence: VA 0101234669) | |
| 208600000X Surgery (Licence: IL 036-157284) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2024-03-11 |