| NPI | 1851491484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX 44811) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NC 33908) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2014-12-10 |