| NPI | 1760418198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 5101017581) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO DR.0066898) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2024-09-13 |