| NPI | 1952911000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: WI 73167) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 7316720) |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2020-08-07 |