| NPI | 1669836193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A158812) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.068424) |
| 2086X0206X Surgery, Surgical Oncology (Licence: CA A158812) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2025-10-02 |