| NPI | 1639438070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: TX Q8567) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10045316) |
| 208600000X Surgery (Licence: TX Q8567) | |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2019-07-01 |