NPI | 1336454933 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD440751) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MD440751) |
Enumeration Date | 2010-08-09 |
Last Update Date | 2011-03-03 |