NPI | 1881007433 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NC 2023-03132) |
Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: MO BB4745785-2014014713) |
Enumeration Date | 2014-06-10 |
Last Update Date | 2024-02-28 |