| NPI | 1326259623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX M6740) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35084045) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2009-06-30 |