| NPI | 1013021666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: PA MD446554) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC 27549) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2017-03-21 |