| NPI | 1598100323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: WA MD61169814) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: IN 01079645A) |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2021-10-15 |