NPI | 1114337466 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: WA MD60946286) |
Additional Taxonomies | 208600000X Surgery (Licence: OR MD198666) |
Enumeration Date | 2014-05-07 |
Last Update Date | 2020-08-27 |