NPI | 1114122355 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: DE C1-0013726) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MD457506) |
2086S0127X Surgery Trauma Surgery (Licence: TN 53123) | |
Enumeration Date | 2007-06-18 |
Last Update Date | 2020-08-13 |