NPI | 1003075755 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA08979400) |
Additional Taxonomies | 208600000X Surgery (Licence: DE C1-0027264) |
Enumeration Date | 2008-06-07 |
Last Update Date | 2024-09-05 |