NPI | 1871750984 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NY 314890) |
Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: TX Q5845) |
Enumeration Date | 2008-05-19 |
Last Update Date | 2022-04-01 |