| NPI | 1700057312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NH 23249) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A91399) |
| 208600000X Surgery (Licence: MO 2008014591) | |
| Enumeration Date | 2008-03-22 |
| Last Update Date | 2022-11-11 |