| NPI | 1932376738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN 55532) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 051492) |
| 208600000X Surgery (Licence: NY 273432) | |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2017-03-27 |