| NPI | 1669738308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: TX T9369) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX T9369) |
| 208600000X Surgery (Licence: CA A131323) | |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2022-10-31 |