| NPI | 1992020754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD218258) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A158678) |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2024-06-14 |