NPI | 1609306646 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MN 76581) |
Additional Taxonomies | 208600000X Surgery (Licence: GA 91249) |
208600000X Surgery (Licence: IL 125.071199) | |
2086X0206X Surgery, Surgical Oncology (Licence: TN 70694) | |
Enumeration Date | 2017-06-13 |
Last Update Date | 2024-06-25 |