NPI | 1750518304 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: OH 57.015155) |
Additional Taxonomies | 208600000X Surgery (Licence: OH 35.124518) |
Enumeration Date | 2009-06-22 |
Last Update Date | 2016-08-02 |