| NPI | 1831624873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MO 2025036343) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01093835A) |
| 208600000X Surgery (Licence: MO 2025036343) | |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2025-10-09 |