| NPI | 1871568709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ME MD19235) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101230875) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2013-09-03 |