NPI | 1073826178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: OR DO171722) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 5101018888) |
Enumeration Date | 2010-07-17 |
Last Update Date | 2015-12-09 |