| NPI | 1114962248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 82540) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL D50663) |
| 2086X0206X Surgery, Surgical Oncology (Licence: FL D50663) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2023-11-15 |