NPI | 1366406639 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: NM MD2006-0484) |
Additional Taxonomies | 174400000X Specialist (Licence: TX G5037) |
Enumeration Date | 2006-04-13 |
Last Update Date | 2018-01-30 |