NPI | 1629210869 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: NM MD2012-0347) |
Additional Taxonomies | 208600000X Surgery (Licence: IL 036.121894) |
Enumeration Date | 2009-04-02 |
Last Update Date | 2023-12-06 |