| NPI | 1144211905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NY 220220) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 220220) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2015-04-06 |