NPI | 1285799668 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: WA MD60101109) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 4301045288) |
Enumeration Date | 2006-12-26 |
Last Update Date | 2023-10-06 |