| NPI | 1184827255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: AZ 41771) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 41771) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2021-01-14 |