| NPI | 1699825802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301105115) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NY 264302) |
| 2086X0206X Surgery, Surgical Oncology (Licence: MI 4301105115) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2019-05-02 |