| NPI | 1063421071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: PA MD031602E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD031602E) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2021-01-18 |