| NPI | 1215904305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MI 4301071254) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301071254) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2025-07-30 |