| NPI | 1770875478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: MO 2019026717) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2019026717) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2025-04-15 |