| NPI | 1053460873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: CA 891220) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A112608) |
| 208600000X Surgery (Licence: CA 891220) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-06-26 |