NPI | 1720311293 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: VA 0101249661) |
Additional Taxonomies | 208600000X Surgery (Licence: ME MD23721) |
Enumeration Date | 2009-09-15 |
Last Update Date | 2020-04-29 |