| NPI | 1871668269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NM MD2019-1062) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NM MD2019-1062) |
| 208600000X Surgery (Licence: MO R8H21) | |
| 208C00000X Colon & Rectal Surgery (Licence: MO R8H21) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2021-11-02 |