| NPI | 1235112293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: PA MD055454L) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD055454L) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2011-02-15 |