| NPI | 1235217985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: CT 69482) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NJ 25MA07917300) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2021-09-28 |