| NPI | 1174697502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MO 2024040742) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: KS 04-51112) |
| Enumeration Date | 2006-11-18 |
| Last Update Date | 2026-02-24 |