| NPI | 1750458758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA G81115) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: CA G81115) |
| 208600000X Surgery (Licence: CA G81115) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2026-08-05 |