| NPI | 1295821569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: IA MD-49622) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 55741) |
| 208C00000X Colon & Rectal Surgery (Licence: MN 55741) | |
| 208C00000X Colon & Rectal Surgery (Licence: TN 61459) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2024-01-02 |