NPI | 1285809541 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA09473600) |
Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA09473600) |
Enumeration Date | 2008-04-28 |
Last Update Date | 2022-03-08 |