| NPI | 1306281308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: AZ 63825) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 58819) |
| 208C00000X Colon & Rectal Surgery (Licence: MN 58819) | |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2021-12-28 |