| NPI | 1609306646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 76581) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: TN 70694) |
| 208600000X Surgery (Licence: IL 125.071199) | |
| 208600000X Surgery (Licence: GA 91249) | |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2024-09-30 |