| NPI | 1174607279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME122685) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: TN MD35370) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2015-01-21 |