| NPI | 1215932223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NC 200000442) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 200000442) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2014-05-02 |