| NPI | 1104878099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX P9059) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: TX P9059) |
| 208600000X Surgery (Licence: TX P9059) | |
| 208600000X Surgery (Licence: MD D43340) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2018-04-30 |