| NPI | 1023308574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: DE C1-0025036) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0025036) |
| 208600000X Surgery (Licence: PA MD471597) | |
| 208600000X Surgery (Licence: DE C1-0025036) | |
| Enumeration Date | 2011-04-17 |
| Last Update Date | 2022-06-16 |