| NPI | 1538125638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: AR E4943) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: LA MD.025523) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2024-01-31 |