| NPI | 1760610307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AR E-13809) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO DR.0053920) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2021-02-12 |