| NPI | 1568423747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX G8265) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: TX G8265) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2008-03-20 |