| NPI | 1730255894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME134651) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01058267) |
| 208600000X Surgery (Licence: CA 149158) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2018-04-24 |