| NPI | 1629091145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CA a69016) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A069016) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2013-04-09 |