| NPI | 1477554780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA07881400) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD430195) |
| 208600000X Surgery (Licence: NJ 25ma07881400) | |
| 208C00000X Colon & Rectal Surgery (Licence: PA MD430195) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2020-10-19 |