| NPI | 1346216157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: CT 73545) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 208404) |
| 2086X0206X Surgery Surgical Oncology (Licence: NY 208404) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2023-03-03 |