NPI | 1205034105 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: IL 036.143945) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 4313090728) |
Enumeration Date | 2007-07-03 |
Last Update Date | 2022-07-21 |