NPI | 1841233608 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: LA 12523R) |
Additional Taxonomies | 208600000X Surgery (Licence: LA 12523R) |
Enumeration Date | 2006-06-13 |
Last Update Date | 2010-10-27 |