| NPI | 1568485423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: LA 09723R) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: LA 09723R) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2010-01-15 |