| NPI | 1780828939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NY 248515) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: CA A107279) |
| 208600000X Surgery (Licence: NY 248515) | |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2013-10-04 |