| NPI | 1518159417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: GA 068527) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 068527) |
| 2086X0206X Surgery, Surgical Oncology (Licence: OH 35.063903) | |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2022-01-04 |