NPI | 1043521685 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MN 54046) |
Additional Taxonomies | 208600000X Surgery (Licence: MN 54046) |
Enumeration Date | 2010-06-29 |
Last Update Date | 2020-08-12 |