| NPI | 1700199809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MI 4301096389) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301096389) |
| Enumeration Date | 2010-07-17 |
| Last Update Date | 2021-02-23 |