| NPI | 1487881983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A135520) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 282539) |
| 208C00000X Colon & Rectal Surgery (Licence: MA 282539) | |
| 208C00000X Colon & Rectal Surgery (Licence: CA A135520) | |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2024-02-21 |