| NPI | 1326006925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: AK 6065) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: WA MD00037698) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2008-06-12 |