| NPI | 1033554886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA11568700) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT203541) |
| 2086X0206X Surgery Surgical Oncology (Licence: NJ 25MA11568700) | |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2024-04-26 |