| NPI | 1215349022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME150711) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME150711) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2021-10-07 |