| NPI | 1801073838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX P7262) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME110824) |
| 208600000X Surgery (Licence: FL ME110824) | |
| 208600000X Surgery (Licence: TX P7262) | |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2014-01-30 |