| NPI | 1558328773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX J2401) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: VA 0101236999) |
| 2086X0206X Surgery, Surgical Oncology (Licence: CA 73195) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: OK 32548) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2017-12-19 |