NPI | 1316099880 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NY 182046) |
Additional Taxonomies | 208600000X Surgery (Licence: NY 182046) |
Enumeration Date | 2007-01-17 |
Last Update Date | 2021-05-10 |