| NPI | 1780777896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: TN 62015) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO T2006012781) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2024-07-07 |