NPI | 1609281690 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MI 4301119290) |
Additional Taxonomies | 208600000X Surgery (Licence: IL 125.064980) |
Enumeration Date | 2014-06-27 |
Last Update Date | 2024-08-31 |