NPI | 1295721751 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: AZ 36598) |
Additional Taxonomies | 208600000X Surgery (Licence: NC 9501173) |
208600000X Surgery (Licence: TX R5080) | |
208600000X Surgery (Licence: NM MD2019-0008) | |
Enumeration Date | 2005-09-21 |
Last Update Date | 2024-04-02 |