NPI | 1871808428 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: PA MD446473) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MT197510) |
Enumeration Date | 2010-08-06 |
Last Update Date | 2018-07-17 |