NPI | 1952756389 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NC 2023-02292) |
Additional Taxonomies | 208600000X Surgery (Licence: FL ME150992) |
208600000X Surgery (Licence: NC 2023-02292) | |
Enumeration Date | 2016-05-04 |
Last Update Date | 2024-04-17 |