| NPI | 1588605778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301101830) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: MO 2000160329) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2020-01-28 |