| NPI | 1528293347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NH 18380) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT195178) |
| 208C00000X Colon & Rectal Surgery (Licence: NH 18380) | |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2019-06-26 |