NPI | 1487846267 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: OR MD160290) |
Additional Taxonomies | 208600000X Surgery (Licence: ZZ 41830) |
208600000X Surgery (Licence: WA 60316843) | |
2086X0206X Surgery, Surgical Oncology (Licence: OR MD160290) | |
Enumeration Date | 2007-08-15 |
Last Update Date | 2025-05-29 |