| NPI | 1669421541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD043249E) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD0043249E) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2016-02-29 |