| NPI | 1063418176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA09547000) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NY 189632) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2025-01-10 |