NPI | 1013396647 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: FL ME150536) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MT207971) |
Enumeration Date | 2015-05-28 |
Last Update Date | 2024-06-27 |