| NPI | 1922056472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NY 175980) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 175980) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2025-08-05 |