NPI | 1245806025 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: ND RL18721) |
Additional Taxonomies | 208600000X Surgery (Licence: TX BP10074490) |
Enumeration Date | 2021-06-02 |
Last Update Date | 2022-06-21 |