NPI | 1154421790 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: MD D08791) |
Additional Taxonomies | 208D00000X General Practice (Licence: MD D08791) |
Enumeration Date | 2006-09-24 |
Last Update Date | 2007-07-08 |