| NPI | 1437513512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX T1770) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: ND 21603) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2025-08-08 |