| NPI | 1740269950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD D46955) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101058729) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2013-12-05 |