| NPI | 1043585185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: GA 83901) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 83901) |
| 208600000X Surgery (Licence: MI 4301103891) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: RI LP04152) | |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2023-10-17 |