| NPI | 1063421766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME148095) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: AZ 51311) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2023-05-18 |