| NPI | 1851581763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: LA 303280) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY 42789) |
| 208600000X Surgery (Licence: AL 31076) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: AL 31076) | |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2016-10-26 |