NPI | 1104853985 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: MN 26370) |
Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: MN 26370) |
Enumeration Date | 2006-06-27 |
Last Update Date | 2007-07-09 |