| NPI | 1114189933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX P6220) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: KY 43479) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2019-11-05 |