| NPI | 1447427661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: OH 35.125272) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: LA 302342) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2021-01-11 |