| NPI | 1720037252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NH 5957) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VT 0420006525) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-03-06 |