| NPI | 1023218286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25IA12717800) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: IA 37504) |
| 2086X0206X Surgery, Surgical Oncology (Licence: PA MD425405) | |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2026-02-04 |