NPI | 1588892574 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: TX Q0493) |
Additional Taxonomies | 208600000X Surgery (Licence: VA 0116021560) |
Enumeration Date | 2009-06-29 |
Last Update Date | 2022-01-04 |