NPI | 1053322719 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CA A65759) |
Additional Taxonomies | 208600000X Surgery (Licence: CA A65759) |
Enumeration Date | 2006-08-10 |
Last Update Date | 2009-12-24 |