NPI | 1235472093 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: OH 35.132854) |
Additional Taxonomies | 208600000X Surgery (Licence: OH 35.132854) |
Enumeration Date | 2013-03-30 |
Last Update Date | 2019-11-20 |