| NPI | 1942239405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME0037515) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: FL ME0035715) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2022-03-08 |