| NPI | 1740325513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: PA MD013482E) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: DE C10006873) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2007-07-08 |