| NPI | 1942286042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101-046926) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101046926) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2022-01-21 |