| NPI | 1144546110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA12107500) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA12107500) |
| 208600000X Surgery (Licence: NC 2017-01625) | |
| 208600000X Surgery (Licence: IN 01070847A) | |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2024-07-01 |