| NPI | 1518126960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: TN 54370) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN MD54370) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2022-03-31 |