| NPI | 1841597127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NM A206317) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OS018004) |
| Enumeration Date | 2011-02-22 |
| Last Update Date | 2025-02-05 |