| NPI | 1336244839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: MD D0066058) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35087599) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2007-09-11 |