| NPI | 1013404375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA 20A25280) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: CA 20A25280) |
| Enumeration Date | 2018-04-21 |
| Last Update Date | 2026-07-08 |