NPI | 1184878555 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: KY IP 1111) |
Additional Taxonomies | 208600000X Surgery (Licence: MO 2015010387) |
Enumeration Date | 2008-11-11 |
Last Update Date | 2024-10-14 |