| NPI | 1801082102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA 00018695) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: ME 013198) |
| 208600000X Surgery (Licence: ME 013198) | |
| 208C00000X Colon & Rectal Surgery (Licence: ME 013198) | |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2024-09-30 |