NPI | 1386899078 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: MD D76143) |
Additional Taxonomies | 208600000X Surgery (Licence: VA 0116019537) |
Enumeration Date | 2008-11-21 |
Last Update Date | 2013-09-23 |