| NPI | 1558604520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NC 2019-02880) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2019-02880) |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2023-10-23 |