| NPI | 1073072054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: OR MD224128) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 250019) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2025-07-31 |