| NPI | 1578599437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AL 26597) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR MD26637) |
| 208600000X Surgery (Licence: NH 22089) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2025-01-22 |