| NPI | 1912393588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME157111) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME157111) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2024-06-06 |