| NPI | 1134377229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NJ 25MA08410600) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NY 239671) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2023-07-03 |