| NPI | 1386802460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: WV 28387) |
| Additional Taxonomies | 208600000X Surgery (Licence: WV 28387) |
| 2086X0206X Surgery, Surgical Oncology (Licence: OH 35092132) | |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2022-04-15 |