NPI | 1093962581 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: VA 0101255226) |
Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: NM MD2007-0633) |
Enumeration Date | 2008-08-26 |
Last Update Date | 2013-12-30 |