| NPI | 1841511219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: TX S7359) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX S7359) |
| 208600000X Surgery (Licence: IL 125.057844) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: CA 146488) | |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2020-10-30 |