| NPI | 1316324965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 74575) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 76723-20) |
| 2086X0206X Surgery, Surgical Oncology (Licence: WI 76723) | |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2023-09-26 |