| NPI | 1164308029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MT233348) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: PA MT233348) |
| Enumeration Date | 2025-08-14 |
| Last Update Date | 2025-09-10 |