| NPI | 1205197340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: OK 34090) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: IN 01078021A) |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2023-07-20 |