NPI | 1033591565 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: IL 036.153027) |
Additional Taxonomies | 208600000X Surgery (Licence: ND RL13724) |
Enumeration Date | 2015-06-20 |
Last Update Date | 2020-09-14 |