NPI | 1730383779 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: PA OS017980) |
Additional Taxonomies | 208600000X Surgery (Licence: DE C2-0010031) |
Enumeration Date | 2007-06-13 |
Last Update Date | 2023-01-12 |