| NPI | 1659454437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 9900231) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 9900231) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2016-08-05 |