| NPI | 1932169547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: TN 60217) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: MS 27346) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2020-01-31 |