| NPI | 1427108950 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208600000X Surgery (Licence: TX G2601) | 
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: TX G2601) | 
| 132700000X Dietary Manager (Licence: TX G2601) | |
| 208200000X Plastic Surgery (Licence: TX G2601) | |
| 146D00000X Personal Emergency Response Attendant (Licence: TX G2601) | |
| Enumeration Date | 2007-01-10 | 
| Last Update Date | 2012-05-22 |