NPI | 1730494741 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NV 20465) |
Additional Taxonomies | 208600000X Surgery (Licence: NC 2013-02230) |
208600000X Surgery (Licence: MA 268463) | |
Enumeration Date | 2010-08-13 |
Last Update Date | 2021-05-26 |