| NPI | 1992233035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX T9531) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10060959) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2026-08-26 |