| NPI | 1861584682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 51586-021) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 02002718A) |
| 208600000X Surgery (Licence: OH 34.009779) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2015-05-07 |