NPI | 1477577542 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: WY 8535A) |
Additional Taxonomies | 208600000X Surgery (Licence: CA A83997) |
208600000X Surgery (Licence: CO 48808) | |
Enumeration Date | 2006-07-26 |
Last Update Date | 2010-12-07 |