NPI | 1790179604 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: IL 036.157404) |
Additional Taxonomies | 208600000X Surgery (Licence: FL ME144221) |
Enumeration Date | 2015-03-28 |
Last Update Date | 2022-01-18 |