| NPI | 1992819809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: LA 019550) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 019550) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2021-03-24 |