NPI | 1992062004 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: LA 310183) |
Additional Taxonomies | 208600000X Surgery (Licence: LA 310183) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-04-13 |
Last Update Date | 2018-09-12 |