| NPI | 1407802929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX P3815) |
| Additional Taxonomies | 208600000X Surgery (Licence: ND 10976) |
| 208600000X Surgery (Licence: CT 054942) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: MO 2002013623) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: CT 054942) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2024-04-18 |