| NPI | 1679539803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 076526) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD071461L) |
| 208600000X Surgery (Licence: MO 2015030565) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: SC 35558) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: MO 2015030565) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2024-03-05 |