| NPI | 1841583572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: FL OS15498) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD P26512) |
| 208600000X Surgery (Licence: FL OS15498) | |
| Enumeration Date | 2011-05-27 |
| Last Update Date | 2020-08-19 |