| NPI | 1124124722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: CA G30403) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G30403) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2015-10-28 |