| NPI | 1942249438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CO DR.0069824) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: FL ME148933) |
| 208600000X Surgery (Licence: TX L6097) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2023-05-09 |