| NPI | 1356300859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: CT 052372) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 052372) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2013-10-08 |