| NPI | 1235324518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME181413) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: AZ 42219) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2026-06-01 |