| NPI | 1922133305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60134916) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60129124) |
| 208600000X Surgery (Licence: DE AT2887175 GS0605) | |
| 208600000X Surgery (Licence: MO 2009009265) | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2022-06-29 |