| NPI | 1194015826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX P3260) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A98580) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2012-10-19 |