| NPI | 1831279009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A76049) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 000000A76049) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2015-07-06 |