| NPI | 1639494834 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX S3217) | 
| Additional Taxonomies | 208600000X Surgery (Licence: TX S3217) | 
| Enumeration Date | 2010-03-30 | 
| Last Update Date | 2022-11-08 |