NPI | 1982676094 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: WA MD00040993) |
Additional Taxonomies | 208600000X Surgery (Licence: WA MD00040993) |
Enumeration Date | 2006-02-02 |
Last Update Date | 2016-09-08 |