| NPI | 1033261680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: AR E5656) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 043833) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2008-09-19 |