NPI | 1689653172 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: TX N6002) |
Additional Taxonomies | 208600000X Surgery (Licence: MO 2004036076) |
208600000X Surgery (Licence: TX 42762) | |
Enumeration Date | 2006-01-12 |
Last Update Date | 2013-07-10 |