| NPI | 1447458484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NY 273373) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60095338) |
| 208600000X Surgery (Licence: WA ML20008997) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: NJ 25MA09961000) | |
| 208600000X Surgery (Licence: NY 273373) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2026-03-18 |