| NPI | 1023241544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: AZ 50783) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 50783) |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2015-07-13 |