NPI | 1821518531 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: CA A167624) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 4301112921) |
Enumeration Date | 2017-06-23 |
Last Update Date | 2025-06-07 |