| NPI | 1801940184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME107615) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD dbose1) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2016-11-09 |