| NPI | 1417219221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: AZ 69616) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA L-252562) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2023-10-03 |