| NPI | 1245512565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101251459) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NY 231941) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2014-08-19 |