NPI | 1942414511 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: CA A111926) |
Additional Taxonomies | 208600000X Surgery (Licence: OH 57-007911) |
Enumeration Date | 2007-05-10 |
Last Update Date | 2013-10-25 |