| NPI | 1386882538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: GA 93968) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 1153) |
| 208600000X Surgery (Licence: MN 68601) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: TN 57791) | |
| 208600000X Surgery (Licence: FL ME118022) | |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2024-01-12 |