| NPI | 1841619038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A197827) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10077253) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2024-08-30 |