NPI | 1235240235 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: PR 016783) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MD429473) |
208600000X Surgery (Licence: IL 036-113950) | |
Enumeration Date | 2006-08-31 |
Last Update Date | 2010-11-04 |