NPI | 1174865703 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: CT 68613) |
Additional Taxonomies | 208600000X Surgery (Licence: MD D0080737) |
208600000X Surgery (Licence: MD P29146) | |
208C00000X Colon & Rectal Surgery (Licence: CT 68613) | |
Enumeration Date | 2013-03-21 |
Last Update Date | 2023-03-15 |