| NPI | 1457518011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: AZ 44643) |
| Additional Taxonomies | 208600000X Surgery (Licence: MS 19131) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2024-04-12 |