| NPI | 1508807819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: LA MD.023556) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 023556) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2021-01-08 |