| NPI | 1750526273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: FL ME126841) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: DC MD037945) |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2022-03-10 |