| NPI | 1306952221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: PA MD433246) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA 025237) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2020-10-22 |