| NPI | 1629489653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: GA 95983) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX T0452) |
| 208600000X Surgery (Licence: PA MT206074) | |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2023-06-28 |