| NPI | 1124127568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 211106) |
| Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: MA 211106) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2019-06-12 |