| NPI | 1023178175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: PA MD043336E) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: CA G79627) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2014-05-08 |