| NPI | 1114214707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: PA MD467101) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX Q7225) |
| 208600000X Surgery (Licence: IL 125.059653) | |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2022-06-21 |