| NPI | 1831753557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.150887) |
| Additional Taxonomies | 208600000X Surgery (Licence: HI MDR-7716) |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2024-06-18 |