NPI | 1336377928 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: AZ 50801) |
Additional Taxonomies | 208600000X Surgery (Licence: AZ R71537) |
Enumeration Date | 2009-06-23 |
Last Update Date | 2022-11-11 |