NPI | 1295763258 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: LA MD.05762R) |
Additional Taxonomies | 174400000X Specialist (Licence: LA 05762R) |
Enumeration Date | 2006-06-29 |
Last Update Date | 2013-09-05 |