| NPI | 1477716835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: TN 52816) |
| Additional Taxonomies | 2083A0300X Preventive Medicine Addiction Medicine (Licence: TN 52816) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2021-07-27 |