| NPI | 1275657207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NV 14316) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY 43337) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2021-08-31 |