NPI | 1548250319 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: VA 0101240573) |
Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: MD D0061324) |
Enumeration Date | 2005-10-24 |
Last Update Date | 2021-07-19 |