| NPI | 1699724021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: KY 20699) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY 20699) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2018-05-21 |