| NPI | 1215042288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 6273962-1205) |
| Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: UT 6273962-1205) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2015-02-12 |