| NPI | 1023166782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: FL ME99677) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL TRN9206) |
| 208600000X Surgery (Licence: FL ME99677) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2021-06-07 |