| NPI | 1912900440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MO 2004032568) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2004032568) |
| Enumeration Date | 2005-05-30 |
| Last Update Date | 2025-04-17 |