| NPI | 1649231671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NH 21965) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 61034-20) |
| 208600000X Surgery (Licence: LA MD205623) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2023-08-08 |