| NPI | 1649566928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2024-02015) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: MO 2019026857) |
| 208600000X Surgery (Licence: MO 2019026857) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2024-09-09 |