| NPI | 1831103878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A32332) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA A32332) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-03-25 |