| NPI | 1568755734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NV DO2859) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 20A12468) |
| Enumeration Date | 2011-05-22 |
| Last Update Date | 2022-02-10 |