| NPI | 1831395433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0052143) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH Training certificate) |
| 208600000X Surgery (Licence: PA MD442931) | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2013-10-22 |