NPI | 1376103606 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: UT 14018337-1204) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 5151013904) |
Enumeration Date | 2019-06-18 |
Last Update Date | 2024-07-11 |