| NPI | 1588632186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NC 2006-00306) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: GA 057406) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2013-01-17 |