| NPI | 1376632547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: CA A80489) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A80489) |
| 2086S0127X Surgery, Trauma Surgery (Licence: CA A80489) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2007-09-17 |