NPI | 1245695808 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: WI 73809-21) |
Additional Taxonomies | 208600000X Surgery (Licence: MO 2015019271) |
Enumeration Date | 2015-12-28 |
Last Update Date | 2023-05-07 |