| NPI | 1164412094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: OH 35.084414) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 36084412) |
| Enumeration Date | 2005-10-22 |
| Last Update Date | 2019-06-12 |