| NPI | 1770769705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: PA MD450519) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2017-01594) |
| 2086X0206X Surgery, Surgical Oncology (Licence: ND 21386) | |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2025-05-27 |