NPI | 1265593396 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: MD D0039061) |
Additional Taxonomies | 208600000X Surgery (Licence: VA 0101044526) |
208600000X Surgery (Licence: DC MD18753) | |
Enumeration Date | 2006-12-13 |
Last Update Date | 2011-11-10 |