| NPI | 1700272333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NH 1370) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 283893) |
| 208600000X Surgery (Licence: MA 264010) | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2023-09-25 |