NPI | 1952572174 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: WA OP60119141) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 5101016461) |
Enumeration Date | 2008-03-14 |
Last Update Date | 2021-04-16 |