| NPI | 1952582397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: AZ 61606) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 068132) |
| 208C00000X Colon & Rectal Surgery (Licence: TX N2443) | |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2021-03-31 |