NPI | 1467458224 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0422741) |
Additional Taxonomies | 208600000X Surgery (Licence: KS 0422741) |
Enumeration Date | 2005-06-24 |
Last Update Date | 2007-07-08 |