NPI | 1508021007 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: GA 90522) |
Additional Taxonomies | 208600000X Surgery (Licence: MS 21411) |
208600000X Surgery (Licence: PA MD448480) | |
Enumeration Date | 2008-07-23 |
Last Update Date | 2024-08-19 |