| NPI | 1497098552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: TX R9495) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA 307695) |
| 208600000X Surgery (Licence: TX R9495) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2023-09-25 |