| NPI | 1134474141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NE 32613) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX Q9021) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2020-12-15 |