NPI | 1902148349 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: WA MD61297014) |
Additional Taxonomies | 208600000X Surgery (Licence: WA MD61297014) |
Enumeration Date | 2013-03-24 |
Last Update Date | 2022-07-20 |