NPI | 1457328304 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: MA 80086) |
Additional Taxonomies | 2086S0129X (Licence: MA 80086) |
208D00000X General Practice (Licence: MA 80086) | |
Enumeration Date | 2006-02-28 |
Last Update Date | 2010-07-02 |