NPI | 1982137378 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: OR MD223869) |
Additional Taxonomies | 208600000X Surgery (Licence: DC MD048181) |
2086S0127X Surgery, Trauma Surgery (Licence: OR MD223869) | |
Enumeration Date | 2017-04-04 |
Last Update Date | 2025-08-13 |