NPI | 1962666263 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: MD D0080365) |
Additional Taxonomies | 208600000X Surgery (Licence: DC MD037369) |
208600000X Surgery (Licence: ME MD19328) | |
Enumeration Date | 2008-07-15 |
Last Update Date | 2016-01-27 |