| NPI | 1720181886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AL MD.27564) |
| Additional Taxonomies | 208600000X Surgery (Licence: AL 00027564) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2024-10-01 |