| NPI | 1801826326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: RI MD12419) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 031562) |
| 208600000X Surgery (Licence: MA 58906) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2024-05-03 |