| NPI | 1174763031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: CO DR.0054993) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: TN 45320) |
| Enumeration Date | 2009-03-04 |
| Last Update Date | 2015-05-15 |