NPI | 1922139898 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CA A79149) |
Additional Taxonomies | 208600000X Surgery (Licence: CA A79149) |
Enumeration Date | 2007-03-09 |
Last Update Date | 2018-12-27 |