NPI | 1124281530 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CT 61554) |
Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: NY 279342) |
Enumeration Date | 2008-07-07 |
Last Update Date | 2018-06-29 |