| NPI | 1508809195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: VA 0101253003) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: OH 35077520) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2022-11-17 |