NPI | 1376863274 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MN 66219) |
Additional Taxonomies | 208600000X Surgery (Licence: MO 2018031091) |
208C00000X Colon & Rectal Surgery (Licence: MO 2018031091) | |
Enumeration Date | 2010-06-03 |
Last Update Date | 2019-08-15 |