| NPI | 1902879729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VT 0420008163) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: VT 0420008163) |
| 2086S0129X Surgery, Vascular Surgery (Licence: VT 0420008163) | |
| 208C00000X Colon & Rectal Surgery (Licence: VT 0420008163) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2007-07-08 |