| NPI | 1508344805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2020-03350) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NC 2020-03350) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2023-12-18 |