| NPI | 1104866748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A606130) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A60613) |
| 2086X0206X Surgery, Surgical Oncology (Licence: CA A606130) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2018-07-19 |