| NPI | 1164505236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NY 191337) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101057753) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2022-11-04 |