| NPI | 1972510592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME102610) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: PA MD034493E) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2015-06-08 |