| NPI | 1982082442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: VT 042-0015446) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: VT 042.0015446) |
| 208C00000X Colon & Rectal Surgery (Licence: MA 283474) | |
| 208600000X Surgery (Licence: RI LP03416) | |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2021-09-07 |