| NPI | 1679705339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MI 4301016293) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301096293) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2025-04-30 |