| NPI | 1992202576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0071078) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR FE214421) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2024-09-12 |