NPI | 1245341635 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: NM A-111099) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 5101010652) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2013-10-11 |