| NPI | 1558789149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: WA MD61564146) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD61564146) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2024-08-06 |