| NPI | 1881973873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: TX U1470) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM MD2016-0006) |
| 208C00000X Colon & Rectal Surgery (Licence: NM MD2016-0006) | |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2023-07-12 |