| NPI | 1033303276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: WA 61363351) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: MO 2018029428) |
| 2086X0206X Surgery, Surgical Oncology (Licence: HI MD-1040) | |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2025-03-18 |