| NPI | 1609938778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: OR MD201911) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60228366) |
| 208600000X Surgery (Licence: MA 217487) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-10-17 |