NPI | 1023496940 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: OK 39325) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208600000X Surgery (Licence: MD D0091959) | |
Enumeration Date | 2015-05-12 |
Last Update Date | 2022-05-21 |