NPI | 1083814933 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Additional Taxonomies | 208600000X Surgery (Licence: PA MD430870) |
Enumeration Date | 2007-07-19 |
Last Update Date | 2009-04-28 |