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Individual

CORNELIUS BOTHA GROENEWALD

Active
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Individual

CORNELIUS BOTHA GROENEWALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
49730
MN
207L00000X
Anesthesiology Physician
Primary
C191676
CA
207LP3000X
Pediatric Anesthesiology Physician
C191676
CA
207LP3000X
Pediatric Anesthesiology Physician
MD 60217883
WA
208600000X
Surgery Physician
49730
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
927687000
MN
Enumeration date
02/12/2007
Last updated
04/10/2024
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