NPI | 1841480217 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: LA 025989) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 025989) |
Enumeration Date | 2007-07-31 |
Last Update Date | 2013-12-04 |