| NPI | 1861471179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 023666) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: CT 023666) |
| 2086X0206X Surgery Surgical Oncology (Licence: CT 023666) | |
| 208C00000X Colon & Rectal Surgery (Licence: CT 023666) | |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2010-07-28 |