| NPI | 1942535786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: VA 0101268501) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101268501) |
| 208600000X Surgery (Licence: CA A130730) | |
| 208600000X Surgery (Licence: NY 254822) | |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2022-03-08 |