| NPI | 1891950879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: DE C1-0011197) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD448105) |
| 208600000X Surgery (Licence: PA MT193108) | |
| 208600000X Surgery (Licence: DE C1-0011197) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2023-04-25 |