NPI | 1003812942 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0062161) |
Additional Taxonomies | 208600000X Surgery (Licence: FL OS14919) |
208600000X Surgery (Licence: PA OS014254) | |
Enumeration Date | 2005-06-24 |
Last Update Date | 2020-04-15 |