| NPI | 1568674067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101274784) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: TX N8679) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2022-11-01 |