NPI | 1508962549 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: PA MD017139E) |
Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA02395700) |
Enumeration Date | 2006-09-16 |
Last Update Date | 2009-07-02 |