NPI | 1073806683 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: NC 2016-01362) |
Additional Taxonomies | 208600000X Surgery (Licence: FL TRN15966) |
Enumeration Date | 2011-05-16 |
Last Update Date | 2021-12-16 |