NPI | 1083714448 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: CA A39749) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 4301038133) |
Enumeration Date | 2006-09-25 |
Last Update Date | 2023-03-07 |