| NPI | 1982618260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AL 00013491) |
| Additional Taxonomies | 208600000X Surgery (Licence: NH 12985) |
| 208600000X Surgery (Licence: OR MD27134) | |
| 208600000X Surgery (Licence: WA MD00047412) | |
| 208600000X Surgery (Licence: ME 017342) | |
| 208600000X Surgery (Licence: WI 50462-20) | |
| 208600000X Surgery (Licence: AK 6533) | |
| 208600000X Surgery (Licence: NE 25254) | |
| 208600000X Surgery (Licence: MS 20888) | |
| 208600000X Surgery (Licence: IN 01070627A) | |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2016-09-01 |