| NPI | 1922362300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MN 76706) |
| Additional Taxonomies | 208600000X Surgery (Licence: MS T-2604) |
| 208600000X Surgery (Licence: TX R3759) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2024-09-09 |