| NPI | 1649260969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX K2407) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX K2407) |
| 2086X0206X Surgery, Surgical Oncology (Licence: TX K2407) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2023-11-20 |