| NPI | 1073723318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NY 275077) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: AK 6895) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-05-20 |