| NPI | 1306376538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MA 1015489) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 271242) |
| 208C00000X Colon & Rectal Surgery (Licence: MN 70847) | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2023-08-04 |