NPI | 1629573555 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: NV LL3253) |
Additional Taxonomies | 208600000X Surgery (Licence: NJ 000000000000) |
Enumeration Date | 2018-03-23 |
Last Update Date | 2019-07-24 |