NPI | 1619056520 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: WA WA MD00027001) |
Additional Taxonomies | 208600000X Surgery (Licence: OR OR MD16429) |
Enumeration Date | 2006-11-02 |
Last Update Date | 2007-07-08 |