| NPI | 1770637068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD D86700) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301108509) |
| 2086X0206X Surgery, Surgical Oncology (Licence: MD D86700) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: TX P3126) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2024-04-19 |