| NPI | 1295826774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX R3617) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA MD10961R) |
| 2086X0206X Surgery, Surgical Oncology (Licence: TX R3617) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: LA 10961R) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2021-10-27 |