| NPI | 1043319940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: TX L5771) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX L5771) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2017-09-13 |