| NPI | 1780746289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: GA 073277) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: VA 0101102746) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2019-02-19 |