| NPI | 1144204462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: MA 155056) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 155056) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2021-05-13 |