NPI | 1134353592 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA11369600) |
Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: NY 241908-1) |
Enumeration Date | 2009-05-13 |
Last Update Date | 2022-07-28 |