| NPI | 1932131414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX M5488) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX BP10017106) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2023-04-21 |