NPI | 1164427639 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: OH 35-047016) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35-047016) |
208C00000X Colon & Rectal Surgery (Licence: OH 35-047016) | |
Enumeration Date | 2005-06-20 |
Last Update Date | 2007-07-08 |