| NPI | 1942430822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 68666) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101248721) |
| Enumeration Date | 2009-07-25 |
| Last Update Date | 2023-10-25 |