| NPI | 1316047152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086H0002X Surgery, Hospice and Palliative Medicine (Licence: MI 4301050975) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301050975) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2019-10-17 |