NPI | 1225236151 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MA 247099) |
Additional Taxonomies | 208600000X Surgery (Licence: MA 247099) |
Enumeration Date | 2007-07-03 |
Last Update Date | 2018-06-18 |