| NPI | 1801039490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: CA C149942) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036112623) |
| 2086X0206X Surgery Surgical Oncology (Licence: TX N4180) | |
| Enumeration Date | 2009-04-12 |
| Last Update Date | 2017-10-30 |