| NPI | 1750354866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: WV 1009) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD066002L) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2018-10-10 |