| NPI | 1245294552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME0072876) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: LA 023027) |
| 208600000X Surgery (Licence: WV 32899) | |
| 208600000X Surgery (Licence: FL ME0072876) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2025-09-08 |