| NPI | 1730594060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IA MD-48955) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0089645) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2021-12-22 |