NPI | 1528300076 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: MD D0087887) |
Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: MD D87887) |
Enumeration Date | 2013-03-22 |
Last Update Date | 2025-03-25 |