| NPI | 1629058342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 208600000X Surgery (Licence: VT 0420011036) |
| Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: VT 0420011036) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2007-07-08 |