| NPI | 1487681102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 1003810220) |
| Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: UT 1003810220) |
| 208C00000X Colon & Rectal Surgery (Licence: UT 1003810220) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2007-07-08 |