| NPI | 1942263710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD032858E) |
| Additional Taxonomies | 208600000X Surgery (Licence: DE C1-0009272) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2012-04-07 |