| NPI | 1568699205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 247290) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME136232) |
| 2086X0206X Surgery, Surgical Oncology (Licence: FL ME136232) | |
| Enumeration Date | 2009-06-21 |
| Last Update Date | 2022-04-20 |