| NPI | 1235389875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME165255) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 056653) |
| 2086X0206X Surgery, Surgical Oncology (Licence: TX U7275) | |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2023-12-08 |