NPI | 1700090602 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: IN 02003840A) |
Additional Taxonomies | 208600000X Surgery (Licence: OH 58001897) |
Enumeration Date | 2007-05-09 |
Last Update Date | 2023-11-16 |