| NPI | 1982608253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: WA MD00041005) |
| Additional Taxonomies | 174400000X Specialist (Licence: IN 01052061A) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2007-12-04 |