NPI | 1275575953 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA09612100) |
Additional Taxonomies | 208600000X Surgery (Licence: OH 35.088373) |
208600000X Surgery (Licence: TX M3214) | |
Enumeration Date | 2006-06-10 |
Last Update Date | 2024-04-29 |