NPI | 1649619115 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: FL ME146486) |
Additional Taxonomies | 208600000X Surgery (Licence: CA A136519) |
2086X0206X Surgery, Surgical Oncology (Licence: FL ME146486) | |
Enumeration Date | 2013-06-18 |
Last Update Date | 2022-12-13 |