| NPI | 1255433983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: AZ 41443) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 127625) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2010-08-11 |