NPI | 1134126576 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: OK 3379) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 3379) |
Enumeration Date | 2005-06-30 |
Last Update Date | 2011-01-05 |