| NPI | 1427001452 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208600000X Surgery (Licence: SC TL32407)  | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC TL32407)  | 
| 208600000X Surgery (Licence: GA 063583)  | |
| 208600000X Surgery (Licence: KY 36338)  | |
| 208600000X Surgery (Licence: SC 32407)  | |
| Enumeration Date | 2006-05-19 | 
| Last Update Date | 2024-12-27 |