| NPI | 1063807550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: ME MD29704) |
| Additional Taxonomies | 208600000X Surgery (Licence: ME MD29704) |
| 208600000X Surgery (Licence: TX R9093) | |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2025-09-05 |