| NPI | 1821018524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: OH 35043837) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35-043837) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2021-01-13 |