NPI | 1497837405 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: AL 00025440) |
Additional Taxonomies | 208600000X Surgery (Licence: OH 35042412A) |
208600000X Surgery (Licence: MN 34132) | |
Enumeration Date | 2006-10-19 |
Last Update Date | 2007-07-08 |