NPI | 1811063134 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: VA 0101039629) |
Additional Taxonomies | 208600000X Surgery (Licence: MD D0033962) |
208600000X Surgery (Licence: DC MD15261) | |
Enumeration Date | 2006-11-28 |
Last Update Date | 2011-10-24 |