| NPI | 1912167065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 60820-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 42178) |
| 2086S0129X (Licence: WI 60820) | |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2025-06-25 |