| NPI | 1609049287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WY 17448C) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO 49155) |
| 208600000X Surgery (Licence: AZ R868) | |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2024-12-13 |