| NPI | 1003889262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 5135057-1205) |
| Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: MA 153899) |
| 2086X0206X Surgery Surgical Oncology (Licence: UT 5135057-1205) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2022-01-10 |