NPI | 1508010273 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: NY AN0768917 I 07) |
Additional Taxonomies | 208600000X Surgery (Licence: NY AL4849622 j14) |
208600000X Surgery (Licence: NY MMIS00243903) | |
Enumeration Date | 2008-11-07 |
Last Update Date | 2008-11-07 |