| NPI | 1124286604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: PA MD426634) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA08642000) |
| 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA08642000) | |
| 208600000X Surgery (Licence: PA MD426634) | |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2017-03-21 |