| NPI | 1548609969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: PA MD455383) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD455383) |
| 208600000X Surgery (Licence: LA 333096) | |
| 2086X0206X Surgery Surgical Oncology (Licence: LA 333096) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2024-10-16 |