NPI | 1558704130 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35.139898) |
Additional Taxonomies | 208600000X Surgery (Licence: OH 35.139898) |
Enumeration Date | 2013-04-12 |
Last Update Date | 2020-09-09 |