| NPI | 1144293119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G84187) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: GA 037479) |
| 2086X0206X Surgery, Surgical Oncology (Licence: CA G84187) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2026-09-25 |