NPI | 1821068826 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: MN 41335) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 41335) |
Enumeration Date | 2006-01-24 |
Last Update Date | 2021-02-11 |