| NPI | 1073511408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME33979) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME0033979) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2020-10-13 |