NPI | 1033748678 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NJ 25MA11395100) |
Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NY 312739) |
Enumeration Date | 2020-04-06 |
Last Update Date | 2025-03-31 |