| NPI | 1588763734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: TN 10156) |
| Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: TN MD 0000010156) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2010-06-15 |