| NPI | 1902355589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: CA SFP33) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: CA SFP33) |
| 208600000X Surgery (Licence: CA SFP33) | |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2018-06-22 |