| NPI | 1316912215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: WA MD60021446) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101239287) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2011-06-13 |