| NPI | 1831230267 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: VA 0101254353) | 
| Additional Taxonomies | 208600000X Surgery (Licence: MN 54648) | 
| 208600000X Surgery (Licence: MN 105451) | |
| Enumeration Date | 2007-02-09 | 
| Last Update Date | 2023-08-09 |