| NPI | 1114181450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: KY 60299) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: OH 35121481) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2026-08-20 |