| NPI | 1740267798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35-066095) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: OH 35-066095) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2007-10-23 |