| NPI | 1215901897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: CA A47782) |
| Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: NJ 25MA08122800) |
| 2086X0206X Surgery Surgical Oncology (Licence: AZ 45166) | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2016-04-14 |