NPI | 1386612414 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: ID M-11186) |
Additional Taxonomies | 208600000X Surgery (Licence: WA 35113) |
208C00000X Colon & Rectal Surgery (Licence: WA 35113) | |
Enumeration Date | 2006-03-14 |
Last Update Date | 2016-11-15 |