| NPI | 1871594143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME105140) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD024542E) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2016-11-09 |