| NPI | 1871538652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MS 16018) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO DR.0071251) |
| 208600000X Surgery (Licence: AK 209728) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2024-12-26 |