| NPI | 1144373176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: AZ 42832) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN A74878) |
| 208C00000X Colon & Rectal Surgery (Licence: CA A74878) | |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2020-09-03 |