NPI | 1407148935 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MS 22344) |
Additional Taxonomies | 208600000X Surgery (Licence: MS 22344) |
Enumeration Date | 2011-05-03 |
Last Update Date | 2021-07-16 |