| NPI | 1437119302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NC 34605) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 34605) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2023-07-03 |