NPI | 1285084087 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: AL 42610) |
Additional Taxonomies | 208600000X Surgery (Licence: MS T-3534) |
208600000X Surgery (Licence: MO 2016012955) | |
Enumeration Date | 2016-06-13 |
Last Update Date | 2023-01-16 |