| NPI | 1982872453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: TX N6835) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD433907) |
| 208600000X Surgery (Licence: DC MD036865) | |
| 208600000X Surgery (Licence: TX N6835) | |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2022-05-18 |