| NPI | 1689603094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35-077683) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35077683) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2011-11-22 |