NPI | 1053402487 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: DC MD037351) |
Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: OH 35-088664) |
208600000X Surgery (Licence: OH 35-088664) | |
208600000X Surgery (Licence: MD D94365) | |
Enumeration Date | 2006-09-28 |
Last Update Date | 2024-01-30 |