NPI | 1497795777 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: NY 236937) |
Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA08079000) |
Enumeration Date | 2006-06-07 |
Last Update Date | 2010-02-25 |