NPI | 1356904361 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: KS 0449361) |
Additional Taxonomies | 208600000X Surgery (Licence: MO 2023048097) |
Enumeration Date | 2019-04-16 |
Last Update Date | 2024-07-22 |