| NPI | 1962758938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: FL ME141977) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL HSE26199) |
| 2086S0102X Surgery Surgical Critical Care (Licence: KY 50398) | |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2019-09-26 |