| NPI | 1669008637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: PA OS026121) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OS026121) |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2026-09-15 |