NPI | 1477501104 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: OH 35.088080) |
Additional Taxonomies | 208600000X Surgery (Licence: WA MD00044204) |
Enumeration Date | 2006-05-05 |
Last Update Date | 2023-02-02 |