| NPI | 1861437386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: KS 27765) |
| Additional Taxonomies | 208600000X Surgery (Licence: KS 04-27765) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2025-10-09 |