NPI | 1124276548 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MN 69081) |
Additional Taxonomies | 208600000X Surgery (Licence: MN 69081) |
Enumeration Date | 2008-08-28 |
Last Update Date | 2022-07-25 |