| NPI | 1942315569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: VA 0101275456) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NE 22537) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2024-09-17 |