| NPI | 1285685495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME143173) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: OH 35.091755) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2021-12-10 |