| NPI | 1295977155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NY 286381) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 012680000) |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2019-01-28 |