| NPI | 1487706255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NY 270778) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MB09093600) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2024-07-19 |