| NPI | 1770757882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NY 229839) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA08391300) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2019-01-21 |