| NPI | 1043308216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX M1557) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: SC 29876) |
| 2086X0206X Surgery, Surgical Oncology (Licence: TX 47178) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2021-09-15 |