| NPI | 1659321073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MN 26582) |
| Additional Taxonomies | 208600000X Surgery (Licence: ND 5139) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2025-09-11 |