| NPI | 1790953644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 9600602) |
| Additional Taxonomies | 2086H0002X Surgery Hospice and Palliative Medicine (Licence: NC 9600602) |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2024-07-15 |