| NPI | 1427425677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA10786100) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD478689) |
| 208C00000X Colon & Rectal Surgery (Licence: PA MD478689) | |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2025-07-22 |