| NPI | 1194165845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.145757) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA R9710) |
| 2086X0206X Surgery, Surgical Oncology (Licence: NY 310531) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2023-02-05 |