| NPI | 1871609933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: WA MD60693493) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60693493) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2026-07-17 |