NPI | 1801982608 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: MO 2017011939) |
Additional Taxonomies | 208600000X Surgery (Licence: KS 04-28199) |
Enumeration Date | 2006-10-05 |
Last Update Date | 2023-08-10 |