| NPI | 1740388669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: PA MD460226) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: AZ 30920) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2017-11-02 |