| NPI | 1942628409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ME MD26382) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101266397) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2023-05-30 |