| NPI | 1316246333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NY 261260) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA09181300) |
| 208600000X Surgery (Licence: NY 261260) | |
| 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA09181300) | |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2021-04-01 |