| NPI | 1295716926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD166758) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: AZ 53543) |
| 2086X0206X Surgery, Surgical Oncology (Licence: OR MD166758) | |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2024-02-28 |