| NPI | 1891916789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL OS14824) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101016438) |
| 208600000X Surgery (Licence: NC 2015-00897) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2024-01-26 |