| NPI | 1093721730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: AZ 53191) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 174011) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2017-03-27 |