NPI | 1952373466 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA06065300) |
Additional Taxonomies | 208600000X Surgery (Licence: NJ MA060653) |
Enumeration Date | 2006-02-07 |
Last Update Date | 2007-07-08 |