NPI | 1457321739 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: WA MD33795) |
Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: WA MD33795) |
Enumeration Date | 2006-01-26 |
Last Update Date | 2011-10-07 |