NPI | 1699980367 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: MT 131349) |
Additional Taxonomies | 208600000X Surgery (Licence: WA OP60226290) |
Enumeration Date | 2007-05-14 |
Last Update Date | 2024-08-06 |