| NPI | 1235394255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NJ 25MA09700900) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA09700900) |
| 2086X0206X Surgery, Surgical Oncology (Licence: NY 239314) | |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2024-04-30 |