| NPI | 1750876645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MT MED-PHYS-LIC-161323) |
| Additional Taxonomies | 208600000X Surgery (Licence: MT MED-PHYS-LIC-161323) |
| 208600000X Surgery (Licence: CA A186420) | |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2025-09-09 |