| NPI | 1154580017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: CA 135300) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 135300) |
| 208600000X Surgery (Licence: FL TRN12753) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2023-04-21 |