NPI | 1457575813 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: AZ 61144) |
Additional Taxonomies | 208600000X Surgery (Licence: SC LL 25038) |
208600000X Surgery (Licence: MO 2008033381) | |
Enumeration Date | 2007-04-13 |
Last Update Date | 2025-01-05 |