| NPI | 1740259563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: GA 51269) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: GA 051269) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2018-03-17 |