| NPI | 1780679787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: IA MD-37234) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA 37234) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2023-11-17 |