| NPI | 1336343235 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX N4049) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: ME MD19902) |
| 2086X0206X Surgery, Surgical Oncology (Licence: MT 11465) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2018-11-21 |