| NPI | 1144291782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: WA 00042328) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA 00042328) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2025-01-08 |