| NPI | 1902021280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD161863) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: CA A96665) |
| 2086X0206X Surgery, Surgical Oncology (Licence: GA 061115) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2025-10-10 |