| NPI | 1366443129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MO 2021000619) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 071202) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2021-03-09 |