NPI | 1295908036 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MN 54908) |
Additional Taxonomies | 208600000X Surgery (Licence: MN 54908) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2008-04-11 |
Last Update Date | 2021-07-02 |