NPI | 1306875570 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: LA 05522R) |
Additional Taxonomies | 208600000X Surgery (Licence: LA 05522R) |
208C00000X Colon & Rectal Surgery (Licence: LA 0522R) | |
207P00000X Emergency Medicine (Licence: LA MD.05522R) | |
Enumeration Date | 2006-07-01 |
Last Update Date | 2014-09-16 |