| NPI | 1609808195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G77498) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: CA G77498) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2016-11-18 |