| NPI | 1841429339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A151367) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301095163) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2021-02-17 |