| NPI | 1033404959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MA 1015526) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: AZ 61811) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2023-05-23 |