| NPI | 1144314709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 050395) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: CT 050395) |
| 2086X0206X Surgery Surgical Oncology (Licence: CT 050395) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-07-11 |