| NPI | 1295182913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: FL ME164010) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10056565) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2023-08-03 |