| NPI | 1932386422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MD D76237) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2008016674) |
| 208C00000X Colon & Rectal Surgery (Licence: MO 2008016674) | |
| Enumeration Date | 2008-01-27 |
| Last Update Date | 2020-03-06 |