| NPI | 1922131994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD436199) |
| Additional Taxonomies | 208600000X Surgery (Licence: DE C7-0003314) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-12-19 |