| NPI | 1255501250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NY 297990-1) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: OH 35.091976) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2019-06-11 |