| NPI | 1093085169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: KY 59244) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX T0725) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2024-06-26 |