| NPI | 1114935749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 9601409) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: PA md424035) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2010-10-20 |