| NPI | 1588099451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MI 4301511316) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301511316) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2024-06-02 |