NPI | 1457581308 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: IA DO-05110) |
Additional Taxonomies | 208600000X Surgery (Licence: OH FU6195413) |
208600000X Surgery (Licence: IA FU6556584) | |
208600000X Surgery (Licence: NE FU6195413) | |
Enumeration Date | 2009-07-24 |
Last Update Date | 2024-04-18 |