| NPI | 1114980570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD027326E) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD027326E) |
| 208C00000X Colon & Rectal Surgery (Licence: PA MD027326E) | |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2018-01-15 |