| NPI | 1538168463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301099706) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 042535) |
| 2086X0206X Surgery, Surgical Oncology (Licence: MI 4301099706) | |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2018-01-26 |