| NPI | 1962408252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: DC MD30905) |
| Additional Taxonomies | 208600000X Surgery (Licence: DC MD30905) |
| 208600000X Surgery (Licence: CT 041334) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2019-09-23 |