NPI | 1851376271 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA08183300) |
Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: NY 176080) |
Enumeration Date | 2005-12-08 |
Last Update Date | 2012-08-24 |