| NPI | 1811280241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: CA A122350) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60838772) |
| 208600000X Surgery (Licence: NY 284470) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: WA MD60838772) | |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2024-05-23 |