NPI | 1043577729 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: ND 15273) |
Additional Taxonomies | 208600000X Surgery (Licence: ND 15273) |
Enumeration Date | 2012-04-18 |
Last Update Date | 2023-06-02 |