| NPI | 1467557835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MI 4301095465) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: VT 0420010490) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2019-02-05 |