| NPI | 1356384499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MI 4301111445) |
| Additional Taxonomies | 208600000X Surgery (Licence: NV 13517) |
| 208600000X Surgery (Licence: OR MD066639) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2021-03-26 |