NPI | 1861461113 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: OH 35094319) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 4301078966) |
Enumeration Date | 2006-03-17 |
Last Update Date | 2011-06-30 |