| NPI | 1063441665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: LA MD.14794R) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 14794R) |
| 208600000X Surgery (Licence: LA MD.14794R) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2023-02-20 |