| NPI | 1164637369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TN MD49078) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2011008004) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2022-11-09 |