| NPI | 1245253897 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: CA G43157) | 
| Additional Taxonomies | 208600000X Surgery (Licence: CA G43157) | 
| Enumeration Date | 2006-07-25 | 
| Last Update Date | 2012-10-19 |