| NPI | 1881007433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NC 2023-03132) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: MO BB4745785-2014014713) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2024-02-28 |