NPI | 1285861120 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: IA MD-50117) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MD450954) |
208600000X Surgery (Licence: TN MD0000056454) | |
208600000X Surgery (Licence: MI 4301094689) | |
208600000X Surgery (Licence: MI 5315041522) | |
208600000X Surgery (Licence: HI MD18168) | |
Enumeration Date | 2009-06-18 |
Last Update Date | 2022-09-30 |