| NPI | 1003228529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD472484) |
| Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: TX S0944) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2022-06-07 |