| 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 | 2019-12-11 |