| NPI | 1780832469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 8351251-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036114739) |
| 2086X0206X Surgery, Surgical Oncology (Licence: UT 8351251-1205) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: TX N6371) | |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2021-10-20 |