| NPI | 1134419161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: PR 18873) |
| Additional Taxonomies | 208600000X Surgery (Licence: PR 18873) |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2024-06-28 |