| NPI | 1770540536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD D66404) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA md422983) |
| 2086X0206X Surgery, Surgical Oncology (Licence: VA 0101239100) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2013-02-07 |