| NPI | 1952333700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MA 205749) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: NH 14991) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2025-03-10 |