| NPI | 1265590434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 233958) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: MA 233958) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2007-09-28 |