NPI | 1417040635 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: OH 35031988) |
Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: OH 35031988) |
Enumeration Date | 2006-10-02 |
Last Update Date | 2007-07-08 |