| NPI | 1568485159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: DC MD210012342) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL me154104) |
| 208600000X Surgery (Licence: LA 14685R) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: LA 014685R) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2023-09-28 |