| NPI | 1043476328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: WA MD61107973) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD61107973) |
| 2086X0206X Surgery, Surgical Oncology (Licence: WI 65874) | |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2020-10-01 |