| NPI | 1790965358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: PA MD457822) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2010-00009) |
| Enumeration Date | 2007-11-11 |
| Last Update Date | 2016-10-04 |