| NPI | 1235138983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: FL ME91364) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME91364) |
| 208C00000X Colon & Rectal Surgery (Licence: KS 0436711) | |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2017-04-09 |