| NPI | 1174580492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME114413) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35072102M) |
| 2086X0206X Surgery, Surgical Oncology (Licence: FL ME114413) | |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2024-05-13 |