NPI | 1952333700 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MA 205749) |
Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: NH 14991) |
Enumeration Date | 2006-07-06 |
Last Update Date | 2023-01-27 |