NPI | 1043283336 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: WY 9756A) |
Additional Taxonomies | 208600000X Surgery (Licence: ID M-9325) |
208600000X Surgery (Licence: MT 12855) | |
Enumeration Date | 2006-02-08 |
Last Update Date | 2023-11-02 |