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 |