| NPI | 1396131074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: OH 35-126472) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: OH 35-126472) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2023-06-07 |