| NPI | 1609096775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: TN MD0000048546) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN MD0000048546) |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2012-07-20 |