| NPI | 1982658225 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME125024) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: OH 35084271) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2025-01-22 |