| NPI | 1316963713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: CA a65396) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A65396) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2022-12-29 |