| NPI | 1992282438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: OK 45002) |
| Additional Taxonomies | 208600000X Surgery (Licence: ND RL15233) |
| 208600000X Surgery (Licence: NV 23992) | |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2026-06-29 |