| NPI | 1811244312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: CA A128624) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A128624) |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2023-03-29 |