NPI | 1164601449 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CA A32290) |
Additional Taxonomies | 208600000X Surgery (Licence: CA A32290) |
Enumeration Date | 2007-11-02 |
Last Update Date | 2016-10-20 |