NPI | 1982851119 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CT 76310) |
Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: NY 259014) |
208C00000X Colon & Rectal Surgery (Licence: FL ME128201) | |
Enumeration Date | 2008-08-19 |
Last Update Date | 2025-09-10 |