| NPI | 1407828387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: VA 0101037527) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: TX H5645) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2009-04-11 |