| NPI | 1083616643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MT 29568) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NY 220692) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2023-11-27 |