| NPI | 1366578098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: TX P7090) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA L-228714) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2019-12-29 |