| NPI | 1932546405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: CO DR.0064119) |
| Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: VA 0116031430) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2020-08-06 |