| NPI | 1801805239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX L0554) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME 99358) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2012-12-18 |