| NPI | 1245496934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 51925) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: MN 51925) |
| 2086X0206X Surgery, Surgical Oncology (Licence: TX Q3193) | |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2020-08-14 |