| NPI | 1942460704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: GA 073813) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 124536) |
| Enumeration Date | 2008-06-14 |
| Last Update Date | 2016-08-17 |