| NPI | 1538570338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: MT MED-PHYS-LIC-115313) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT205957) |
| 208600000X Surgery (Licence: IN 01085487A) | |
| 2086X0206X Surgery Surgical Oncology (Licence: WI 71125-20) | |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2024-02-19 |