NPI | 1376049817 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: FL ME175449) |
Additional Taxonomies | 208600000X Surgery (Licence: CO DR.0073780) |
Enumeration Date | 2018-04-03 |
Last Update Date | 2025-08-05 |