| NPI | 1700892387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: TN 53326) |
| Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: FL ME91419) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2015-09-22 |