| NPI | 1669436044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: VA 0101260875) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: WV 17901) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2016-11-08 |