| NPI | 1841678133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 5101025663) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5315218427) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2020-06-16 |