| NPI | 1235320474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: CT 62463) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 256848) |
| 208600000X Surgery (Licence: PA MD432356) | |
| 2086X0206X Surgery Surgical Oncology (Licence: NY 256848) | |
| 2086X0206X Surgery Surgical Oncology (Licence: PA MD432356) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2019-07-30 |