| NPI | 1215997564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: LA MD.10222R) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: LA 1022R) |
| 2086X0206X Surgery, Surgical Oncology (Licence: GA 034346) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2013-06-17 |