| NPI | 1477789972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX R9236) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX R9236) |
| 208600000X Surgery (Licence: MA L-241203) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: CA 141964) | |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2019-09-11 |