NPI | 1760801260 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: CA A139029) |
Additional Taxonomies | 208600000X Surgery (Licence: OR MD210154) |
Enumeration Date | 2014-04-11 |
Last Update Date | 2023-07-18 |