NPI | 1548495641 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: MO 30508) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 30508) |
Enumeration Date | 2009-05-19 |
Last Update Date | 2009-05-19 |