| NPI | 1295804052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A82485) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NY 280363) |
| 2086X0206X Surgery, Surgical Oncology (Licence: KY 51413) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2018-08-01 |