| NPI | 1992944284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: LA 333529) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 45063) |
| 208C00000X Colon & Rectal Surgery (Licence: AZ 45063) | |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2022-10-03 |