| NPI | 1750762001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CA A202668) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: AZ 65328) |
| 2086S0105X Surgery, Surgery of the Hand (Licence: CA A202668) | |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2025-11-18 |