NPI | 1265515043 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: WA MD60066486) |
Additional Taxonomies | 174400000X Specialist (Licence: NC 9300547) |
Enumeration Date | 2006-10-23 |
Last Update Date | 2021-07-16 |