NPI | 1568513703 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: WA MD00039844) |
Additional Taxonomies | 174400000X Specialist (Licence: WA MD00039844) |
Enumeration Date | 2007-01-15 |
Last Update Date | 2010-06-14 |