| NPI | 1871531624 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NC 2007-00781)  | 
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: CA A86379)  | 
| 208600000X Surgery (Licence: NC 2007-00781)  | |
| Enumeration Date | 2006-06-03 | 
| Last Update Date | 2007-10-05 |