NPI | 1710979869 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MI RD006962) |
Additional Taxonomies | 208600000X Surgery (Licence: MI RD006962) |
Enumeration Date | 2005-08-16 |
Last Update Date | 2024-09-17 |