| NPI | 1467440073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: TX G0977) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX G0977) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2022-03-30 |