NPI | 1619192341 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MA 242017) |
Additional Taxonomies | 208600000X Surgery (Licence: MA 242017) |
Enumeration Date | 2007-04-16 |
Last Update Date | 2016-11-14 |