| NPI | 1508209800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: PA MD483865) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD483865) |
| 208C00000X Colon & Rectal Surgery (Licence: CA A173275) | |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2024-08-14 |