| NPI | 1215964754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AL 18186) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 49253) |
| 2086X0206X Surgery, Surgical Oncology (Licence: AL 18186) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2023-03-09 |