NPI | 1306979208 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: CA C168048) |
Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA07918500) |
Enumeration Date | 2007-03-13 |
Last Update Date | 2021-11-10 |