NPI | 1710906136 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: NY 212039) |
Additional Taxonomies | 208600000X Surgery (Licence: VT 042.0012371) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2014-11-11 |