| NPI | 1710972906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AL MD.9132) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.9132) |
| 207Q00000X Family Medicine (Licence: AL MD9132) | |
| 208600000X Surgery (Licence: AL 9132) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: AL MD.9132) | |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2022-04-04 |