| NPI | 1144472168 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX 46196) | 
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: CA A138794) | 
| 208600000X Surgery (Licence: TX 46196) | |
| Enumeration Date | 2008-10-22 | 
| Last Update Date | 2018-06-18 |