NPI | 1639128788 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: OH 35-06-3217) |
Additional Taxonomies | 174400000X Specialist (Licence: OH 35063217) |
174400000X Specialist (Licence: OH 35-06-3217) | |
Enumeration Date | 2006-05-08 |
Last Update Date | 2021-12-10 |