| NPI | 1457748980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: OK 41848) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01087036A) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2026-01-20 |