| NPI | 1164585329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA10029900) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 188072) |
| 2086X0206X Surgery, Surgical Oncology (Licence: NY 188072) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2024-05-02 |