NPI | 1528023447 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CO 0056140) |
Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: OH 35087432) |
Enumeration Date | 2006-04-20 |
Last Update Date | 2017-05-15 |