| NPI | 1184944019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: TX Q6820) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10037833) |
| 208600000X Surgery (Licence: TX Q6820) | |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2022-01-31 |