NPI | 1386818060 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: MI 4301095232) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MD434232) |
Enumeration Date | 2008-04-15 |
Last Update Date | 2023-04-19 |