| NPI | 1932366309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: MI 4301099714) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301099714) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2018-07-20 |