NPI | 1770789570 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 202C00000X Independent Medical Examiner (Licence: LA 013131) |
Additional Taxonomies | 208600000X Surgery (Licence: LA MD.013132) |
Enumeration Date | 2007-06-27 |
Last Update Date | 2019-09-25 |