| NPI | 1245452366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NE 4574) |
| Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: RI MD12615) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2014-10-30 |