NPI | 1295752988 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: WI 57302-20) |
Additional Taxonomies | 208600000X Surgery (Licence: OH 35081883) |
Enumeration Date | 2006-07-17 |
Last Update Date | 2012-11-15 |