| NPI | 1992886667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 041931) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 041931) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2016-03-30 |