| NPI | 1881868347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.098301) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301083501) |
| 208600000X Surgery (Licence: IN 01075147A) | |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2026-04-06 |