| 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 |