| NPI | 1174513527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX N8210) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: VA 0101044597) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2022-01-07 |