| NPI | 1740448505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: KS 04-37980) |
| Additional Taxonomies | 208600000X Surgery (Licence: KS 04-37980) |
| 208600000X Surgery (Licence: KS 6968) | |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2021-07-30 |