NPI | 1942639091 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CO DR.0061282) |
Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: PA MD450149) |
Enumeration Date | 2013-11-08 |
Last Update Date | 2024-02-06 |