| NPI | 1114037439 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: NE 18448) | 
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NE 18448) | 
| Enumeration Date | 2006-08-30 | 
| Last Update Date | 2014-01-03 |