NPI | 1982676094 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CO DR.0069984) |
Additional Taxonomies | 208600000X Surgery (Licence: WA MD00040993) |
2086S0127X Surgery, Trauma Surgery (Licence: CO DR.0069984) | |
208C00000X Colon & Rectal Surgery (Licence: WA MD00040993) | |
Enumeration Date | 2006-02-02 |
Last Update Date | 2024-07-09 |