| NPI | 1578583779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2008-00828) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NC 2008-00828) |
| 2086X0206X Surgery, Surgical Oncology (Licence: TX M3474) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2025-10-06 |