| NPI | 1730115106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: TX N7542) |
| Additional Taxonomies | 208600000X Surgery (Licence: OK 24058) |
| 208600000X Surgery (Licence: TX N7542) | |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2024-05-01 |