| NPI | 1841433760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NY 281263) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD448752) |
| 208600000X Surgery (Licence: AZ 51645) | |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2025-04-11 |