| NPI | 1104027135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: PA OS014080) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: TX L7008) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2024-08-15 |