| NPI | 1740443316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME128415) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A125937) |
| 208600000X Surgery (Licence: AL 33414) | |
| 208600000X Surgery (Licence: KS 94-07082) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2025-01-13 |