| NPI | 1780751677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: HI MD-16645) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: CA G78509) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2021-06-09 |