NPI | 1578087250 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: PR 22747) |
Additional Taxonomies | 208D00000X General Practice (Licence: PR 33394) |
208600000X Surgery (Licence: WV 32752) | |
Enumeration Date | 2017-08-03 |
Last Update Date | 2025-09-10 |