NPI | 1922096817 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: OH 35053968) |
Additional Taxonomies | 174400000X Specialist (Licence: OH 35053968) |
Enumeration Date | 2005-10-13 |
Last Update Date | 2011-12-14 |