NPI | 1568459477 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: MD D0101863) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MD07185L) |
208600000X Surgery (Licence: NC 2008-01864) | |
Enumeration Date | 2005-10-05 |
Last Update Date | 2024-10-24 |