| NPI | 1639461882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: OH 35.121395) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.121395) |
| Enumeration Date | 2011-05-06 |
| Last Update Date | 2014-08-25 |