| NPI | 1841464443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NE 29903) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX M8305) |
| 208C00000X Colon & Rectal Surgery (Licence: SC 33699) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2019-11-20 |