| NPI | 1750458758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: CA G81115) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G81115) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2022-06-08 |