NPI | 1477603660 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MA 74572) |
Additional Taxonomies | 208600000X Surgery (Licence: MA 74572) |
Enumeration Date | 2007-01-11 |
Last Update Date | 2011-03-08 |